Health Affairs October 1, 2024
Abstract
For nearly a half-century, Congress has created various legal authorities from among which states may select to provide Medicaid beneficiaries with long-term services and supports (LTSS) in home and community-based settings, instead of in institutions. This article describes these legal authorities and their genesis and contends that a simpler architecture would better serve program goals. In theory, state-level variation could shine a light on how Medicaid can best...